Have you ever considered a black market in uteruses?

In 2014, the first child to have been gestated in a donated uterus was born in Sweden. Although research into uterus transplantation is still in an early phase, many see the donations as a success. But are there ethical complications as well?

Thus far, trials around the world have resulted in the birth of ten children who were gestated in a transplanted uterus; eight of them in Sweden.

“If uterus transplantation is to take the step from trials to becoming a reality in the Swedish healthcare system, there must first be an ethical debate on the procedure,” says Lisa Guntram, of Linköping University.

In 2016 a Swedish white paper on altruistic surrogacy argued that altruistic surrogacy should not be permitted. With this as a starting point, Guntram analysed the assumption that introducing uterus transplantation would be less problematic than altruistic surrogacy. Her research was conducted together with Nicola Jane Williams, of Lancaster University in the UK, and the results of the study have been produced in the journal Bioethics.

Some of the issues include:

1.That the transplant can threaten the autonomy of the donor, and subject her to pressure. In the Swedish trials, the donated uteruses come from a relative, in most cases the mother of the woman who is involuntarily childless. Consequently, some close relatives of involuntarily childless people can feel forced to donate, or be actively subject to external pressure.

2.That the intervention can lead to exploitation of women's bodies. There is a risk uteruses might become yet another organ, such as kidneys, on the black market.

3.That the research on the physical and psychological risks facing the child is inadequate. As in surrogacy contexts, little is known of the consequences of uterus transplantation for the child, because so few children have been born as a result of such a transplantation.

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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